Audit of a series of 40 gastrointestinal stromal tumour cases
Audit of a series of 40 gastrointestinal stromal tumour cases
复制标题
DOI：
10.1016/j.ejso.2006.05.018
复制
发表时间：
2006-12-01
期刊：
影响因子：
3.8
通讯作者：
Faendrich, F.
中科院分区：
文献类型：
--
作者：
Hinz, S.;Pauser, U.;Faendrich, F.
目的：分析影响胃肠道间质瘤切除术后生存和肿瘤复发的预后因素。方法：对我院40例GIST手术患者进行回顾性分析。根据肿瘤大小、有丝分裂率和CDI - 17阳性情况对患者进行分类。考虑到局部肿瘤切除与部分器官切除的比较，采用Kaplan-Meier法计算总生存期和无病生存期。结果：肿瘤分布于食道、胃、十二指肠、小肠、大肠和直肠。根据肿瘤大小和有丝分裂计数，65%的患者有中等或高风险GIST。40例患者中有26例采用节段性器官切除，其余患者均采用局部切除。平均总生存期为73个月。局部肿瘤切除后的无病生存期明显优于节段性器官切除（73个月vs 53个月；P=0.05）。肿瘤大小大（p=0.07）和有丝分裂计数高（p=0.14）是影响无病生存的负向预后因素，但尚未达到统计学意义。结论：原发性手术是治疗原发性和复发性GIST的基础。风险适应性手术是避免早期肿瘤复发的最重要因素。在肿瘤小的情况下，可以避免部分器官切除，有利于肿瘤复发风险低的局部肿瘤切除。(c) 2006 Elsevier Ltd.版权所有。
Aims: To analyze prognostic factors influencing survival and tumour recurrence after resection of gastrointestinal stromal tumours.Methods: Forty patients who underwent surgery for a GIST at our institution were reviewed. Patients were classified on the basis of tumour size, mitotic rate and CDI 17 positivity. The overall survival and disease free survival were calculated using Kaplan-Meier method considering the extent of surgery comparing local tumour excisions with segmental organ resections.Results: Tumours were localized in the oesophagus, stomach, duodenum, small bowel and large bowel and rectum. Sixty-five percent of the patients had an intermediate or high risk GIST according to tumour size and mitotic count. In 26/40 patients tumour resection was performed using segmental organ resection, in all other patients local tumour excision was carried out. The mean overall survival was 73 months. Disease free survival was significantly better after local tumour excision compared to segmental organ resection (73 months versus 53 months; P=0.05). Large tumour size (p=0.07) and high mitotic count (p=0.14) were negative prognostic factors for disease free survival, although statistical significance was not reached yet.Conclusion: Primary surgery remains the cornerstone in the treatment of primary and recurrent GIST. Risk adapted surgery is the most important factor to avoid early tumour recurrence. In case of small tumour size segmental organ resections can be avoided favouring local tumour excisions with a low risk of tumour recurrence. (c) 2006 Elsevier Ltd. All rights reserved.